At least half of adults have some kind of problem with dilated veins. This common condition is a family problem for many people. Women are at least twice as likely to develop varicose veins as men. Among both sexes, it affects 25% to 60% of adults, depending on age.
Dilated veins do not always look like convex bluish strands; sometimes varicose veins appear as a thin vascular mesh running just under the surface of the skin. It almost always affects the legs and feet. Visible swollen and tortuous veins - sometimes surrounded by patches of congested capillaries, resembling a spider web or spider veins - are superficial varicose veins. Although they are often painful and disfiguring, they are most often harmless. When inflammation develops, such veins become dense to the touch and can impede blood circulation to such an extent that swelling of the ankles, itching and pain in the affected limb develop.
In addition to the superficial network of veins, the legs have an internal, or deep, venous network. In rare cases, the deep veins of the legs are also affected by varicose veins. These deep varicose veins are usually not visible, but they can cause swelling or pain throughout the leg and - most dangerously - can be a site for blood clots.
To help circulate oxygenated blood from the lungs to all parts of the body, arteries have a thick muscular lining. For the reverse flow of blood through the venous system, the surrounding muscles are used, the muscle layer at the venous wall is thin and weak, but the veins are equipped with internal valves that allow blood to pass in only one direction - towards the heart, the valves are needed to prevent the reverse flow of blood.
With varicose veins, the valves do not work correctly, causing blood to pool in the vein and making it difficult for the muscles to push the blood "up. "Instead of flowing from one valve to the other, blood continues to pool in the vein, increasing venous pressure and further impairing the valves, causing the vein to bulge and become tortuous. Because superficial veins have less muscle support than deep veins, they are more prone to varicose veins.
What contributes to the development of varicose veins?
Any condition that involves excessive strain and pressure on the legs or abdomen can lead to varicose veins. The most common factors that cause intra-abdominal pressure are pregnancy, obesity, and work that requires standing for long periods of time or heavy lifting. Chronic constipation, prostate adenoma that requires straining during bowel movements and urination and, in rare cases, tumors can also cause varicose veins. A sedentary lifestyle contributes to the development of varicose veins, since muscles that are not working do not pump blood well.
The likelihood of varicose veins increases with age as muscles and veins weaken. Previous leg trauma can damage the venous valves and contribute to the development of varicose veins. Genetics also plays a role, so if other family members have varicose veins, you are more likely to have them too. Contrary to popular belief, sitting cross-legged does not cause varicose veins, although it may aggravate an existing condition.
Can you prevent varicose veins?
Although genetics plays a role in your risk of developing varicose veins, there are things you can do to prevent them:
- Exercising regularly because staying in good physical shape is the best way to keep your leg muscles toned, improve blood circulation and control your weight. It is believed that among all types of fitness, swimming and aqua aerobics have the greatest preventive effect;
- Healthy weight support; if you are overweight or even obese, then losing weight will reduce the risk of developing varicose veins, since normal weight prevents excess pressure on the veins of the legs;
- Avoiding tight clothing. Tight clothing can constrict blood flow in the thighs, groin, and legs;
- Avoid frequent and prolonged wearing of high-heeled shoes, as they can impede blood circulation. Shoes with completely flat soles are also undesirable; it is better to choose shoes with low and stable heels or elastic elastic soles, as they are better for blood circulation and also improve the tone of the calf muscles.
- Movement! Prolonged sitting or standing should be avoided to stimulate blood circulation. If your daily routine requires you to be on your feet a lot, consider wearing a daily support jersey. Stretch your legs and exercise as often as possible to improve circulation and reduce venous pressure.
- Fight against smoking. Research shows that smoking may contribute to the development of varicose veins.
- During pregnancy, you should sleep on your left side, not your back. This will reduce the pressure of the uterus on the veins in the pelvic area and even improve blood supply to the fetus;
- If you have risk factors for developing varicose veins, then ask your doctor to choose compression stockings for you - these could be special socks, stockings or tights.
Spider veins and varicose veins
As we age, many of us find bumpy, bluish stars under our skin or swollen cords spreading down our thighs and calves. These deformed blood vessels occur in 60% of adults after age 50.
What are spider veins?
Spider veins are small, tortuous blood vessels that show through the skin. They can be red, purple or blue in color and most often appear on the legs or face.
What are varicose veins?
These are larger blood vessels that have lost their elasticity, swollen and acquired a tortuous course due to changes in the venous wall. Such veins appear bluish and raised above the surface of the skin. Varicose veins can appear anywhere, but most commonly they develop on the legs, thighs, and feet.
What causes spider veins and varicose veins?
Healthy veins collect blood from the capillary network and carry it from the periphery to the heart through a system of one-way valves. These valves direct blood flow in the desired direction from the superficial veins to the deeper veins and to the heart. The vessels are surrounded by muscles that contract and help pump blood to the heart. Normally, healthy venous valves prevent backflow of blood. However, problems with the valves, muscles, or blood pressure can cause blood to pool inside the vein. When blood pools in a vein, pressure increases and the vein wall weakens. As a result, the vein becomes bulging and tortuous. As a result, depending on the caliber of the blood vessel and the degree of swelling, a network of spider veins or varicose veins is formed.
Who is at risk for varicose veins?
Spider veins or varicose veins of large veins can appear in any person, but women are susceptible to this problem twice as often as men. This problem is also familiar to those whose jobs require them to be on their feet constantly, including nurses, hairdressers, lecturers and teachers. Other factors that trigger the development of varicose veins include aging, obesity, pregnancy, injury or surgery to the leg, and a family history of varicose veins.
What symptoms are accompanied by varicose veins?
Often, spider veins and/or varicose veins are not just an unpleasant cosmetic defect. Varicose veins are a disease that can cause unpleasant symptoms and dangerous complications, in particular, pain or cramps in the legs, sensations of heaviness, throbbing or tingling. Severely inflamed veins become hard to the touch and reduce circulation, leading to itchy and swollen ankles. Also, over time, trophic changes in the skin and subcutaneous tissue develop, such as induration, pigmentation and ulceration.
Complications of varicose veins
Although spider veins and varicose veins spoil the appearance of the legs and cause uncomfortable symptoms, they rarely pose a serious threat to health. However, in some cases, complications may develop that require a visit to the doctor and even hospitalization.
The most common complications of varicose veins are trophic ulcers against the background of long-term venous insufficiency; such ulcers most often form in the ankle area and heal very poorly. The second frequent and more dangerous complication of varicose veins is thrombophlebitis - thickening and inflammation of the venous wall, which in turn can lead to venous thrombosis - a dangerous complication requiring hospitalization and intensive treatment. If thrombosis has developed in the deep vein system, then there is a danger of migration of the blood clot, the so-called thromboembolism, and as a result of thrombophlebitis, chronic post-thrombophlebitis disease can develop, which significantly affects the patient’s quality of life and performance.
Diagnosis of varicose veins of the lower extremities
It is easy to diagnose spider veins and varicose veins of the superficial veins - a visual examination is enough. However, the primary diagnostic complex always includes an ultrasound examination of the deep vein system, since superficial dilated veins may indicate insufficiency of the valves of the deep veins of the lower extremities, which requires a serious approach to treatment. During the examination, the doctor always pays attention to the swelling of the ankles, the symmetry of the swelling, if present, compaction of the venous wall and subcutaneous tissue, changes in skin color, pigmentation, pain, and the presence of trophic ulcers.
Most cases of spider veins and varicose veins, unless accompanied by venous insufficiency, do not require surgical treatment, but can be removed for cosmetic purposes. If varicose veins are accompanied by complaints such as heaviness in the legs, pain, muscle fatigue or cramps, swelling of the ankles, then there are treatment recommendations that will reduce the symptoms and slow down the progression of the disease.
Treatment of varicose veins
Therapeutic approaches to varicose veins can be conservative and surgical. The choice of therapy method can be made by a phlebologist based on examination and examination. The purpose of examination for varicose veins is to determine the stage of the disease and the risk of developing possible complications. Such an examination, which includes a thorough examination, ultrasound examination of the veins of the lower extremities, and in some cases, laboratory tests.
Who treats varicose veins?
A phlebologist treats diseases of the veins of the lower extremities. A phlebologist is a doctor with a surgical specialty, which is based on training first in general surgery and then in cardiovascular surgery. Phlebology is a branch of vascular surgery that deals with the study and treatment of diseases and malformations of the venous system. A phlebologist surgeon must be proficient in a wide range of techniques used in the treatment of venous diseases.
Conservative treatment of varicose veins
Conservative therapy for varicose veins is aimed at slowing its development and preventing complications. Usually it consists of recommendations for lifestyle changes (weight loss, proper physical activity, elimination of static loads that contribute to the progression of the disease), selection of compression stockings, prescription of medications that tonic the walls of venous vessels, and prescription of a course of physiotherapy.
Compression jersey – support socks, stockings and tights
The easiest way to prevent the progression of varicose veins is to wear support stockings. Also called compression stockings, they improve blood circulation and relieve pain and discomfort in the legs. They can be found in pharmacies and specialty medical supply stores. Such stockings are especially necessary during pregnancy and during long flights.
Lifestyle change may also help prevent the rapid development of varicose veins. First of all, you need to normalize your weight and introduce physical activity into your life, such as walking or swimming; exclude frequent wearing of high heels, static loads and a sedentary lifestyle.
Drug treatment – there are many drugs, both in the form of gels and creams, and in the form of tablets, which have a venotonic effect and affect the rate of progression of varicose veins, slowing down its development. However, their action can only be effective in combination with other preventive measures.
Physiotherapy – for varicose veins, both in the early stages and in advanced forms of the disease, pressotherapy is most often used - a course of physiotherapy using compression - sequential compression of the veins with specialized circular pads, the pressure in which spreads from the feet to the hips, improving blood flow, stimulatingvascular wall and normalizing the functioning of venous valves. This treatment is prescribed 2-4 times a year in courses of 10-12 procedures. It is also recommended to be carried out after sessions of sclero- and laser therapy for varicose veins. Such physiotherapy can be carried out either independently or in combination with specialized electrical stimulation of the leg muscles, with the expectation of mutually enhancing the therapeutic effect.
Other situations in which physiotherapy gives good results are trophic changes in the skin caused by advanced stages of varicose veins; in these cases, laser therapy, magnetic therapy, phono- and electrophoresis (→ and other methods) can be prescribed. It should be remembered that it is 100% contraindicated forphysiotherapy for varicose veins is concomitant thrombosis or thrombophlebitis, therefore, before conducting a course of physiotherapeutic procedures, you shouldundergo an ultrasound examination of the veins of the lower extremities.
Surgical and minimally invasive treatment of varicose veins and its complications
Patients, most of whom are women and girls, because varicose veins most often affect the fair half of humanity, come to see a phlebologist because of the external side of the disease - they are bothered by unsightly spots and cords on their legs. Treatment of varicose veins in this situation most often involves eliminating cosmetic defects. For this purpose, minimally invasive methods of treating varicose veins are used - sclerotherapy and endovenous laser coagulation (EVLC).
The term "minimally invasive" in relation to medical procedures means "low-traumatic" and "gentle". Indeed, such treatment is carried out on an outpatient basis, causes minimal pain, comparable to a regular injection, and allows you to achieve excellent results. This treatment consists of destroying the inner wall of the vein with a drug (sclerosant) or laser, which leads to the lumen of the vessel sticking together and the disappearance of the cosmetic defect.
In each case, the decision on the treatment method is made by the doctor based on the examination and examination. In cases of complicated varicose veins, surgical treatment is used, which is carried out in a hospital setting.